Hospitals Should Tread Carefully On Hygiene Monitors

from the beeeeep! dept

Researchers have invented a device (via the Raw Feed) to remind hospital workers to wash their hands between patients. Bad hygiene is a serious problem in hospitals, because diseases can be spread from patient to patient. Unfortunately, doctors and nurses are often in a hurry and forget to wash up. The device tries to increase washing rates by installing infrared sensors over patient beds. When a health care worker comes near a patient, the system will try to detect whether the health care worker has washed his hands since seeing the last patient, and beeps if he has not. It's a clever idea, but it seems to have a few problems. For one thing, it sounds like it only detects when a worker has disinfected using special alcohol dispensers included with the system. A soap and water washing doesn't count, as far as the system is concerned. It also can't detect if a health care worker has gone near a patient but not touched him or her. The big problem such a system would face is having health care workers view it as an annoyance rather than an asset. If the system frequently beeped at them when they weren't doing anything wrong, they might start ignoring or even trying to disable it.

I think the key to making it work would be to make sure hospital workers view it as a helpful way to improve their own performance rather than a way of nagging them or penalizing them when they forget to wash their hands. Wearing the things would be irritating enough without having to worry about getting disciplined when the system made a mistake. One good approach might be to allow workers to disable the beeping feature, but continue collecting data about hand-washing rates. Even if the data weren't perfect, it would be good enough to collect data on hygiene rates in different parts of the hospital. Those parts that showed lower-than-average hygiene could receive additional training.

Reader Comments

Not useful...

One good approach might be to allow workers to disable the beeping feature, but continue collecting data about hand-washing rates.

That's a false metric, and generating any reporting on that metric would lead to workers gaming the system (unless you did it in a way that could be conceived as spying on them). and we all know how happy people get when they know their company is spying on them.

I see absolutely no merit in this device. It doesn't measure anything of value. It attempts to measure an abstract (cleanliness) without actually measuring it, or its inverse (dirtiness). Dirtiness is only relevant due to the possible proliferation of bacteria on the skin. Why not just build something that measures bacteria? Too hard? That is the price of success. You have to do something hard.

I'd normally say one or two layers of abstraction can still yield useful results in data aggregation, but this is three layers of abstraction. Any information gathered is completely useless. The only actionable results a system like this should be able to provide is to let the health care administrators know who is a god awful slob. And if they have to rely on an extreme like this to tell, they have bigger problems.

No Way

As a former health care professional I have been critical of a lot of practices seen in the field. They got this one wrong, however. Good hand washing is strongly emphasized at all levels of practice. Forgetting to wash hands is actually a rare occurrence in most health care institutions. It sounds like these "researchers" are trying to hype a useless product.

GIGO, again (meow)

It is very difficult to understand how you see that the system, as described, provides any useful data about the incidence of unwashed hands on patients. It appears to record the events of hand disinfection and staff-patient proximity, with time, staff and patient dimensions; nothing about infected hands touching patients, and another affirmation of the fundamental law of information processing - Garbage In, Garbage Out. If you really want to find something positive to say about this, then I think the best that can be said is that is collects data on staff using disinfectants at the washing basin, and, separately, incidents of staff being in close proximity to patients.

In reality this article is actually part of your research on "Are Blog Comments Like a Laser Pointer to a Cat?". meow!

Alignment of Incentives

A highly effective way to manage people, and supply chains, is to align incentives. Make it so that doctors, nurses, etc get a bonus based on rates of ocurrance of MRSA spreads etc.(lower rates equal higher bonuses). Carrot AND stick, not just stick.

Re: Alignment of Incentives

The spread of these illnesses are so random its not much of an incentive.

But we don't need bribes or fancy technological solutions to what is essentially a management problem (its like trying to use politics to solve a business model problem ^^).

Quality needs to be built in to everyday working practices by definition, it needs to be part of the culture of these professions. Unfortunately what people fail to realize is that doctors and nurses have many pressures on them to work at a certain pace (in the UK there are top-down targets imposed by the Government).

When pressure is placed upon a service to meet certain performance targets and costs the first thing to suffer is quality. Unfortunately, the Managers often consider the best solution to be more targets.

Staph, SARS, the unexposed patient

This is a real, tangible issue, but as usual one part of establishment blames another- as long as the subject establishment contains a human to control- the doctor and nurse.

We COULD just make a window the doctor walks up to so there is NO danger- and we COULD slow the speed limit nationally to 45 mph- I agree, hundreds of thousands of lives saved in just a year or three. But we dont do it- because we are a country of Humans. We compete with other (less spoiled, second place) Humans. They will consume our lead and us, with vengeance, while we play blame games.

Also: Hospitals are (including every one, and the best hospitals I have been in) places where a person who does not mix it up with new people very often (stays at ranch, for example) can come to a hospital and get a foot-rotting disease from using their showers (with foot covers, etc) because the intensity of the "bugs" (whatever you call it) is so strong- they can go right through PVC slippers.

That was in 1996, almost all better now. Note: Doctors would not tell me (in this one instance) why I got the problem foot- they just look at it, call a conference, have others look, call others, repeat.

I assure you there is an issue here needing remedying. Washing hands is misdirection; the most dangerous, strong, treatment resistant, "bugs" are residents at every hospital, no pun.